Presented  by 
Eula  G.  Waiters,  r.  0. 


COLLEGE    OF    OSTEOPATHIC    PHYSICIANS 
AND  SURGEONS  •    LOS  ANGELES,  CALIFORNIA 


\Osteopathic 

Strap  Technic 


I 


BY 


7 
JOSEPH  SWART,  D.  O.,  LL.  B. 


Professor  of 

Physical    Diagnosis    and    Analysis    of    Words    in 
the  Kansas   City   College  of  Osteopathy   and 
Surgery;   Author   of  "Analysis   of  Words 
Pertaining    to    Anatomy,    Physiology, 
Diseases    and    Surgery    for    Stud- 
ents   and    Physicians". 


PUBLISHED  BY 

JOSEPH  SWART 

650    Minnesota    Ave.,  Kansas    City,    Kansas 


Copyright,   1919 

By  JOSEPH  SWART,  D.  O. 


P RE  FA  C  E 


Osteopathic  strap  technic,  properly  used,  ob- 
tains desirable  results  in  a  manner  agreeable 
to  the  patient  and  without  exhausting  the  op- 
erator. The  straps  do  part  of  the  work  and 
the  patient  does  part  of  it,  while  the  operator 
directs  and  assists  the  operation. 

Every  osteopath  who  is  doing  a  successful 
business  should  conserve  as  much  of  his  energy 
as  possible.  The  early  deaths  and  failing 
health  among  the  overworked  men  and  women 
of  the  osteopathic  profession  should  be  a  warn- 
ing to  others. 

A  practice  is  bound  to  increase  in  amount, 
from  year  to  year,  provided  it  is  properly  man- 
aged and  the  results  obtained  are  satisfactory 
to  the  patients.  Furthermore,  the  results  will 
be  satisfactory  in  nearly  all  chronic  cases,  if 
the  lesions  are  corrected.  Therefore,  the  suc- 
cess of  an  osteopath  is  dependent  on  his  skill 
in  technic.  A  proper  diagnosis  is  fundamental ; 
but,  the  technic  is  what  cures  the  patient  and 
the  cure  is  what  most  concerns  him. 

With  the  aid  of  straps,  many  lesions  can  be 
easily  corrected  that  are  otherwise  difficult  or 


22834 


impossible  to  correct.  Many  patients  have 
told  of  the  unpleasant,  painful  and  exhausting 
experiences  endured  while  osteopaths  were 
trying  to  correct  innominate  lesions.  Such 
osteopathic  work  is  detrimental  to  the  patient, 
to  the  operator's  professional  reputation  and 
to  the  reputation  of  osteopath}-.  Such  work  is 
unnecessary  and,  accordingly,  should  be 
avoided.  It  is  so  easy,  with  a  strap,  to  correct 
these  lesions  that  there  seems  no  good  reason 
why  any  osteopath  should  not  use  one.  In- 
deed, the  only  equipment  necessary  for  cor- 
recting innominate  lesions  is  one  stout  strap 
about  eight  feet  long. 

Everj-  general  osteopathic  practitioner 
should  endeavor  to  specialize  in  technic,  be- 
cause his  success  and  the  reputation  of  osteop- 
athy depends  upon  it. 

Strap  technic  is  not  expected  to  revolutionize 
osteopathic  methods  of  treatment,  neither  is  it 
a  complete  system  of  technic;  yet,  it  is  an  aid 
of  inestimable  value  to  the  osteopathic  pro- 
fession. It  may  be  hoped,  that  any  osteopath 
who  uses  strap  technic  will  thereby  become 
so  much  more  efficient  in  his  work  that  his 
patients  will  have  a  higher  esteem  for  his 
work  and  for  osteopathy. 


EQUIPMENT  FOR  OSTEOPATHIC  STRAP 
TECHNIC. 

The  necessary  equipment  for  osteopathic 
strap  technic  is  five  handles,  six  straps,  with 
two  short  straps  attached  to  one  of  the  six, 
and  one  harness  strap,  in  addition  to  one  ordi- 
nary treatment  table  and  a  pillow. 

The  five  handles  can  be  secured  at  any  good 
hardware  store.  They  are  the  kind  used  on 
screen  doors  or  for  raising  heavy  windows. 

The  straps  may  be  webbing  or  leather. 
Leather  straps  may  be  ordered  from  a  harness 
maker ;  webbing  straps,  from  a  trunk  factory. 

One  handle  should  be  placed  at  the  front  of 
the  table.  For  convenience,  this  should  be 
placed  in  the  center  and  at  the  highest  avail- 
able point  on  the  front  end  of  the  table.  (Not 
on  top.) 

On  either  side  of  the  table  there  should  be 
two  handles;  one  about  fifteen  inches  and  the 
other  about  thirty,  from  the  head  end. 

It  is  advisable  to  use  one  leather  strap  about 
eight  feet  long,  one  and  one-half  inches  wide, 
made  of  the  thickest  leather  the  harnessmaker 
has.  This  strap  will  do  for  all  the  heavy  work 
and  will  last  years.  A  weaker  strap  will  soon 
be  torn  tq  pieces. 

The  webbing  straps  needed  are  the  follow- 
ing :  Two,  one  and  one-half  inches  wide,  eight 
feet  long;  two,  one  and  one^ha4f  inches  wide, 


two  and  one-half  feet  long;  one,  one  inch 
wide,  fourteen  feet  long.  Each  of  these  web- 
bing straps  should  have  a  buckle  at  one  end 
and  a  tip  piece  at  the  other. 

On  the  fourteen-foot  strap,  about  four 
feet  from  the  buckle,  fasten,  at  right  angles, 
a  webbing  strap  six  inches  long  with  a  buckle 
on  its  free  end.  About  seven  feet  from  the 
buckle  end  of  this  fourteen-foot  strap,  fasten, 
at  right  angles,  a  webbing  strap  forty  inches 
long,  with  a  metal  tip  piece  on  the  free  end 
of  it. 

The  harness  snap  should  be  put  on  this 
fourteen-foot  strap ;  then  the  ends  of  the  strap 
should  be  buckled  together.  The  snap  is  for 
hooking  into  the  handle  at  the  end  of  the 
table,  while  the  strap  is  put  over  the  patient's 
shoulders,  as  shown  in  Plates  16  and  17. 


OSTEOPATHIC  STRAP  TECHNIC. 


Plate    1— TECHNIC    FOR    CORRECTING   A    POS- 
TERIOR  INNOMINATE  LESION 

Note,  in  the  Plate,  that  the  strap  is  buckled 
short  enough  to  flex  slightly  the  patient's 
knee  ;  and,  that  it  passes  across  the  patient's 
hip  just  below  the  crest  of  the  ilium  on  the 
lesioned  side  and  just  above  the  crest  of  the 
ilium  on  the  normal  side. 

Instruct  the  patient  to  push  hard  with  his 
foot  against  the  strap.  The  strap  pulls  the 
crest  of  the  ilium  forward  and  the  head  of  the 


femur  pushes  the  acetabulum  backward,  thus 
correcting  the  lesion. 

If  the  patient  is  a  child  or  an  adult  too 
feeble  to  push  hard  against  the  strap,  the 
operator  should  press  downward  on  the  pa- 
tient's knee  to  straighten  the  leg.  That  will 
do  the  work  just  as  well  as  when  the  patient 
does  the  pushing.  This  operation  should  be 
painless  and  agreeable  to  the  patient. 

By  this  strap  method,  innominate  lesions 
can  be  corrected  for  women  while  they  are 
fully  dressed  for  the  street. 

It  is  just  as  easy  to  correct  a  big  man's  in- 
nominate lesion  as  it  is  to  correct  one  for  a 
little  patient ;  the  patient  does  the  work. 

An  anterior  lesion  can  be  set  in  the  same 
manner  by  moving  the  strap  down,  from  the 
crest  of  the  ilium  to  the  ischium,  and  having 
the  patient  push  as  before. 


Plate   2- 


-TECHNIC   FOR   CORRECTING   ANTER- 
IOR  INNOMINATE  LESIONS 


PLATE    2— TECHNIC    FOR    CORRECTING 
ANTERIOR  INNOMINATE   LESION. 


As  shown  in  this  Plate,  the  strap  is  put 
through  the  handle  at  the  front  end  of  the  table 
and  looped  over  the  patient's  knee.  The  strap 
should  be  buckled  up  to  the  proper  length  to 
reach  over  the  knee  when  the  thigh  is  perpen- 
dicular. Then  instruct  the  patient  to  push  with 
his  knee,  as  hard  as  he  can  against  the  strap. 
By  so  doing  he  corrects  the  lesion.  The  ham- 
string muscles  draw  the  ischium  anteriorly 
and  the  glutens  maximus  opens  the  sacroiliac 
articulation,  while  the  head  of  the  femur 
pushes  the  acetabulum  posteriorly,  thus  cor- 
recting the  lesion. 


Plate   3— TECHNIC   FOR   CORRECTING   AN   AN- 
TERIOR   INNOMINATE    LESION    WITH- 
OUT USING  A  STRAP 


PLATE    3— TECHNIC    FOR    CORRECTING 

AN  ANTERIOR  INNOMINATE  LESION 

WITHOUT  USING  A  STRAP. 

The  patient  interlocks  the  fingers  of  his 
hands  and  puts  them  over  the  knee  to  take  the 
place  of  the  strap.  The  patient  should  pull 
with  both  hands  and  push  with  his  knee,  with 
all  his  strength.  He  should  not  bend  his  elbows, 
as  by  doing  so  he  draws  the  knee  too  far  for- 
ward. This  method  can  be  used  when  the 
operator  has  no  strap  to  work  with.  If  he 
has  a  strap,  it  is  best  to  use  it,  as  the  patient 
will  push  harder  on  the  strap  than  he  will  on 
his  hands 


10 


Plate   4— TECHNIC   FOR   CORRECTING   AN   AN- 
TERIOR   INNOMINATE    LESION    ON    A 
BED  OR  SOFA 


11 


PLATE  4— TECHNIC  FOR  CORRECTING 

AN  ANTERIOR  INNOMINATE  LESION 

ON  A  BED  OR  SOFA. 

Sometimes  a  treatment  is  given  at  the  pa- 
tient's home,  with  the  patient  on  a  bed  or  sofa. 
In  such  cases,  there  may  be  nothing  to  fasten 
a  strap  to.  A  broom  handle,  or  any  old  stick, 
can  be  used  as  shown  in  this  Plate.  I  usually 
put  the  strap  over  my  wrist  and  grasp  the 
head  of  the  sofa  or  bed  with  my  hand  and  let 
the  patient  push  with  all  his  might.  Since  I 
should  consider  that  method  dangerous  for  an 
operator  who  has  an  arm  smaller  than  mine, 
I  am  advising  the  use  of  a  stick,  as  shown  in 
Plate  4. 


12 


Plate    5— TECHNIC   FOR   CORRECTING   AN  AN- 
TERIOR   INNOMINATE    LESION    WHEN 
THE  PATIENT  HAS  A  SORE  KNEE 


13 


PLATE    5— TECHNIC    FOR    CORRECTING 

AN  ANTERIOR  INNOMINATE  LESION, 

WHEN  THE  PATIENT  HAS  A 

SORE  KNEE. 

Synovitis  of  a  knee  joint  is  a  common  re- 
sult of  an  innominate  lesion ;  therefore,  it  is 
quite  common  to  find  a  sore  knee  associated 
with  this  lesion.  On  account  of  the  soreness, 
place  the  strap  on  the  thigh  just  above  the 
knee.  It  is  usually  necessary  to  put  a  small 
pillow  between  the  patient's  thigh  and  the 
strap,  as  the  pressure  against  the  strap  may 
cause  pain. 

Sometimes  a  patient  will  complain  of  pain 
between  the  sacrum  and  the  posterior  superior 
spine  of  the  ilium.  This  can  be  removed  by 
hooking  the  strap  over  the  front  corner  of  the 
table,  opposite  the  affected  side  and  over  the 
patient's  knee  while  he  lies,  in  the  dorsal  posi- 
tion on  the  table.  Then  let  the  patient  push,  as 
he  would  for  correcting  an  anterior  innominate 
lesion.  By  this  method,  the  pull  will  be  in 
proper  direction  for  opening  the  joint  at  the 
point  of  pain  and  for  removing  the  cause  of 
the  pain. 

No  preparatory  treatments  are  necessary  be- 
fore making  innominate  corrections.  Correct 
the  lesion,  and  then,  if  desirable,  treat  the  mus- 
cles. 

14 


The  innominate  lesion  is  very  common.  Soir- 
osteopaths   say  that  eighty  per  cent  of  th?' 
chronic  cases  have  innominate   lesions.     I  do 
not  keep  case  records,  but  I  should  judge  trr. 
eighty  per    cent   is   not    far  out   of    the   \vr 
Every    one    of    these    lesions    cause    trouble — 
trouble  that  an  osteopath  can  remove  by  r 
recting  them.     If  he  successfully  treats  every 
innominate  lesion  that  comes  to  him,  he   will 
make  a  sufficient  number  of  cures  to  build  a 
reputation  for  successful  practice. 

It  will  not  be  necessary  to  enumerate  the 
various  diseases  and  ailments  that  have  been 
cured  by  correcting  innominate  lesions ;  but, 
in  a  general  way,  it  is  well  to  know  that  such 
lesions  cause  congestion  and  pain  anywhere 
in  the  legs,  feet,  pelvis  or  lower  abdominal  re- 
gion. They  also  interfere  with  the  circulation 
of  blood  in  all  the  parts  just  mentioned,  and 
gradually  or  suddenly,  develop  trouble  of  va- 
rious natures,  from  varicose  veins  to  neo- 
plasms. 

A  double  innominate  lesion  often  exists,  that 
is,  a  Lesion  of  both  innominate  bones.  In  such 
cases,  the  legs  are  of  equal  length.  If  there  is 
pelvic  trouble  or  trouble  anywhere  in  the  legs, 
feet  or  lower  abdominal  region,  not  otherwise 
accounted  for,  it  is  well  to  suspect  a  double 
innominate  lesion.  To  test  for  such  a  lesion, 
give  treatment  for  an  anterior  innominate 

15 


lesion,  and  then  measure  the  legs.  If  the  leg 
so  treated  is  shorter  than  the  other,  there  was 
a  double  lesion.  Treat  the  other  lesion  in  the 
same  manner  and  measure  again.  The  legs 
will  again  be  of  equal  length.  Don't  be  afraid 
to  make  this  test ;  there  is  no  danger  of  pro- 
ducing an  innominate  lesion  by  this  treatment. 
Theoretically,  one  might  fear  that  such  treat- 
ment of  a  normal  articulation  would  lesion  it ; 
but,  experience  of  over  five  years  has  proved 
that  there  is  no  danger  of  so  producing  a 
lesion. 

Instead  of  calling  this  a  double  lesion,  some 
osteopaths  may  argue  that  it  is  a  slipped 
sacrum.  If  so,  let  them  call  it  that.  It  makes 
no  difference  in  the  treatment  and  no  differ- 
ence in  the  results. 

Why  do  patients  travel  many  miles  to  get 
their  innominate  lesions  corrected  by  the  strap 
method?  To  answer  this  question,  it  is  neces- 
sary only  to  hear  them  relate  their  experiences 
with  osteopaths  trying  to  correct  such  lesions 
by  the  old  methods.  It  is  difficult  to  under- 
stand why  any  osteopath  should  stick  to  his 
old  methods  of  manipulation,  when  he  knows 
that  such  methods  are  often  unsuccessful  and 
usually  very  unpleasant  to  the  patient.  The 
old  methods  lose  business ;  the  strap  method 
gets  it,  always  making  the  corrections  and  pro- 
ducing good  results. 


16 


Plate   6— TECHXIC   FOR   CORRECTING  A   LUM- 
BAR  LORDOSIS.   OR  FOR  TREATING  A 
RIGID  LUMBAR 


17 


PLATE  6— TECHNIC  FOR  CORRECTING  A 
LUMBAR  LORDOSIS,  OR  FOR  TREAT- 
ING A  RIGID  LUMBAR. 

In  this  process,  there  is  but  one  strap  used. 
It  passes  around  the  table,  through  one  handle 
at  the  side  of  the  table  and  over  the  patient's 
knees.  When  the  patient  pushes  with  his 
knees  against  the  strap,  it  places  a  strain  on 
the  erector  spinea  muscles.  For  each  pound 
of  pressure  exerted  by  the  knees  there  is  about 
seven  pounds'  strain  put  on  the  erector  spinea 
and  quadratus  lumborum  muscles.  Most  of 
it  is  put  on  the  erector  spinea  muscles.  Any 
average  man  can  easily  in  this  position  raise 
three  or  four  hundred  pounds  on  his  knees. 
That  would  mean  a  strain  of  2,100  to  2,800 
pounds  on  the  erector  spinea  muscles.  The 
treatment  stretches  these  muscles ;  hence,  it  is 
especially  good  for  correcting  lumbar  lordosis. 
Such  a  spine  throws  extra  weight  on  the  an- 
terior portion  of  the  base  of  the  sacrum  and 
tilts  the  pelvic  girdle.  This  abnormally  tilted 
condition  interferes  with  the  circulation  of 
blood  thorugh  the  pelvic  basin  and  impedes 
circulation  of  blood  and  lymph  throughout  the 
legs  and  feet. 

By  this  treatment,  I  have  cured  varicose 
veins  of  both  legs  after  they  were  bad  enough 
to  necessitate  the  patient's  wearing  rubber 

18 


bandages  to  prevent  the  veins  from  breaking 
out. 

For  years  I  sought  for  a  successful  treat- 
ment of  lumbar  lordosis,  but  I  did  not  find  it 
until  I  learned  the  technic  shown  in  Plate  31. 
When  I  was  in  college,  I  was  shown  how  to 
treat  such  cases  by  laying  the  patient  on  his 
side,  flexing  his  knees  and  pressing  them  with 
my  chest  while  I  reached  over  the  patient's 
side  and  pulled  on  the  erector  spinea  muscles. 
That  was  hard  work  for  me  ;  but  it  was  easy 
on  the  erector  spinea  muscles.  The  treatment 
was  practically  worthless.  The  erector  spinea 
muscles  are  probably  the  most  powerful  in  the 
human  body  and  it  requires  great  force  to  at» 
feet  them. 

Next  to  the  correction  of  innominate  lesions 
to  normalize  the  blood  circulation  in  the  pelvis 
and  legs,  the  most  important  thing  is  the  cor- 
rection of  a  lumbar  lordosis. 

These  cases  of  lumbar  lordosis  are  very  com- 
mon, as  they  are  found  in  most  portly  people 
and  in  many  slim  ones.  They  are  productive 
of  much  trouble.  It  is  very  necessary  that  this 
condition  should  be  corrected. 

If  the  patient's  hips  do  not  rise  from  the 
table  when  he  pushes  on  the  strap,  the  strap 
should  be  slipped  from  his  knees  and  he  should 
be  asked  to  slide  about  three  inches  toward 
the  foot  of  the  table.  Put  the  strap  over  his 

19 


knees  and  let  him  push  again.  The  further  the 
patient  moves  toward  the  foot  of  the  table,  the 
higher  the  strain  will  be  on  his  back  when  he 
pushes  on  the  strap.  Don't  allow  the  patient 
to  push  against  his  knees  with  his  hands,  for 
that  does  the  spinal  muscles  no  good. 

This  treatment  can  be  used  very  success- 
fully to  loosen  up  a  stiffened  lumbar  spine, 
but  I  would  not  recommend  it  for  vise  on  a 
posterior  condition  of  the  lumbar  spine,  be- 
cause, in  such  cases,  it  is  detrimental. 

Don't  try  this  treatment  with  a  weak  strap, 
for,  if  you  do,  the  strap  will  break  and  the 
erector  spinea  muscles  will  receive  no  benefit. 


20 


Plate     7— TECHNIC     FOR    TREATING    HEMOR- 
RHOIDS OR  REPLACING  FALLEN  PEL- 
VIC ORGANS 


21 


PLATE  7— TECHNIC  FOR  TREATING 
HEMORRHOIDS  OR  FOR  REPLAC- 
ING FALLEN  PELVIC  ORGANS. 

No  strap  is  used  in  this  treatment.  The  pa- 
tient is  lying  on  two  pillows,  so  that  her  body 
can  be  rocked  back  and  forth  longitudinally 
with  ease.  The  operator  pushes  on  the  patient's 
feet  to  rock  her  body  toward  the  head  of  the 
table ;  then  he  pulls  and  pushes  again  to  get 
it  under  good  motion.  After  pushing  the  second 
time,  the  operator  holds  back  on  the  feet  to 
stop  suddenly  the  forward  movement  of  the 
body.  As  he  makes  this  sudden  stop,  the  mo- 
mentum carries  the  abdominal  and  pelvic  con- 
tents upward. 

This  treatment  requires  a  little  practice,  but, 
after  the  opertor  becomes  familiar  with  it,  he 
can  do  great  good  with  it. 

Whenever  I  have  told  osteopaths  that  this 
treatment  would  cure  hemorrhoids  in  from  one 
to  five  treatments,  they  looked  at  me  doubt- 
fully. Years  of  experience,  however,  have  led 
me  to  believe  that  this  treatment  will  cure 
ninety-five  per  cent  of  hemorrhoid  cases  in 
from  one  to  five  treatments.  In  some  cases  of 
hemorrhoids,  there  is  an  accumulation  of  dried 
blood  in  the  tumor.  This  treatment  cannot  re- 
move that  dried  blood. 

Long  standing  cases  are  not  necessarily  dif- 

22 


ficult  to  cure.  I  cured  one  case  of  hemorrhoids 
of  nineteen  years'  standing  in  a  single  treat- 
ment. 

The  question  naturally  arises,  Why  is  this 
treatment  so  effective?  It  is  because  it  re- 
moves the  cause  of  hemorrhoids,  folds  in  the 
bowel.  The  bowel  becomes  jammed  and 
pressed  down  at  the  rectum,  putting  short 
folds  in  its  walls.  These  short  folds  shut  off 
the  circulation  of  blood  and  the  blood  is  held 
back,  causing  the  veins  to  fill  and  enlarge. 
This  enlargement  is  a  hemorrhoid.  Whenever 
the  bowel  is  raised  up  by  this  treatment,  the 
short  folds  are  straightened  out,  and  the  blood 
is  allowed  to  circulate  freely.  The  hemorrhoid 
drains  and  disappears.  This  is  a  simple  technic 
easily  understood.  The  cures  are  just  as  easily 
made. 

By  this  same  treatment  we  can  raise  the 
fallen,  flexed  or  verted  uterus.  If  the  uterus 
is  tipped  backward  against  the  sacrum,  the 
patient  should  be  treated  while  she  lies  face 
downward.  In  that  position  gravitation  aids 
the  uterus  in  its  replacement  by  drawing  it 
away  from  the  sacrum.  When  giving  the  treat- 
ment with  the  patient  lying  face  downward, 
it  will  be  necessary  for  her  to  keep  the  knees 
perfectly  rigid.  If  the  knees  are  springy,  the 
treatment  will  be  useless,  as  the  body  must  be 
stopped  suddenly,  for  the  momentum  to  carry 

23 


the  uterus  upward  to  its  normal  position,  and 
this  cannot  be  done  if  the  knees  are  not  rigid. 

The  AIcManus  table  is  convenient  for  this 
treatment,  as  the  patient  can  be  put  on  it  with 
her  head  lower  than  her  hips,  making  the 
treatment  more  effective. 


24 


Plate  8— TECHXIC   FOR   TREATING   LEUCHOR- 
RHEA   OR    MEXORRHAGIA 


25 


PLATE  8— TECHNIC  FOR  TREATING 
LEUCORRHEA  OR  MENORRHAGIA. 

The  strap  is  placed  across  the  lower  lumbar 
region.  The  operator  raises  the  patient's  knees 
as  high  as  she  will  tolerate.  The  knees  should 
be  raised,  in  this  manner,  three  times  for  a 
treatment. 

The  results  thus  obtained  for  leucorrhea  are 
very  satisfactory,  and  if  continued,  will  cure 
most  cases.  One  treatment  will  stop  any 
normal  mensis,  although  more  than  one  may  be 
required  for  abnormal  conditions.  The  treat- 
ment is  quickly  given,  and  is  too  valuable  to  be 
omitted  when  needed. 


Plate    9— TECHNIC    FOR    TREATING    THE    AN- 
TERIOR ABDOMINAL  AND  CHEST  WALLS 


27 


PLATE  9— TECHNIC  FOR  TREATING  THE 

ANTERIOR  ABDOMINAL  AND 

CHEST  WALLS. 

No  strap  is  used  in  this  treatment.  A  pillow 
is  laid  at  the  center  of  the  table.  The  patient 
lies  across  it  as  shown  in  this  plate.  His  feet 
do  not  touch  the  floor. 

The  patient's  arms  are  raised  above  the  head 
to  draw  on  the  pectoralis  muscles  and  raise  the 
chest  walls.  After  a  patient  has  had  this  treat- 
ment several  times,  a  weight  can  be  held  in  his 
hands  to  make  the  stretch  greater. 

This  treatment  is  especially  good  for  cases 
of  tharacic  kyphosis.  In  such  cases  the  ribs 
are  slanted  too  far  downward,  anteriorly.  The 
abdominal  muscles  are  contracted  and  short- 
ened. Contractured  intercostal  and  abdominal 
muscles  make  it  impossible  to  straighten  the 
spinal  column.  They  must  be  stretched  and 
relaxed.  This  treatment  will  do  the  work. 

Stooped  shoulders,  with  their  accompanying 
distorted  chest,  make  a  suitable  place  for  a 
multitude  of  diseases,  affecting  especially  the 
nervous  system,  heart,  lungs,  and  bronchial 
tubes.  This  treatment  shown  in  Plate  38  is 
good  for  a  multitude  of  cases.  It  is  not  hard 
on  the  operator.  At  first  it  is  very  severe  on 
the  patient.  Later  he  can  take  it  with  pleasure. 

The  length  of  time  a  patient  should  lie 
across  the  table  depends  on  his  toleration. 

28 


Some  patients  do  not  wish  to  lie  there  more 
than  ten  seconds.  They  often  breathe  heavily 
after  this  treatment,  as  though  they  had  tried 
to  lift  a  ton.  Some  patients  can  lie  there  a 
minute  and  repeat  the  exercise  three  or  four 
times  for  a  treatment.  Some  patients,  after 
practice,  can  lie  five  minutes  and  hold  a  ten- 
pound  weight  in  their  hands.  Each  operator 
should  try  this  treatment  before  he  gives  it  to 
any  of  his  patients  ;  then  he  will  know  what 
to  expect  of  the  patient.  Put  a  patient  across 
the  table  as  shown  in  Plate  9,  pal.oate  the  mus- 
cles of  the  chest  and  abdomen  and  note  how 
taut  they  are.  You  will  decide  that  this  is  £. 
powerful  treatment. 


Plate    10— TECHNIC 
OR  TO   STOP  A 


TO    PREVENT    VOMITING 
STOMACH  HEADACHE 

30 


PLATE  10— TECHNIC  TO  PREVENT  VOM- 
ITING OR  TO  STOP  A  STOMACH 
HEADACHE. 

When  a  patient  complains  of  a  headache  that 
affects  the  eyes  and  forehead,  place  one  finger 
on  the  right  side  of  the  spine,  at  the  fourth 
thoracic  nerve,  to  see  if  the  spot  is  hypersen- 
sitive. If  so,  the  stomach  is  the  cause  of  the 
headache.  Hold  one  finger  on  this  spot  to 
inhibit  the  nerve  from  one  to  three  minutes 
and  the  headache  will  have  cleared  up.  It  is 
not  necessary  to  count  the  vertebrae  to  locate 
this  hypersensitive  nerve.  Guess  at  the  spot 
and  press.  If  that  spot  is  not  hypersensitive, 
try  the  one  above  or  the  one  below.  The  pa- 
tient will  tell  you  when  you  hit  the  right  spot. 

If  the  stomach  is  in  bad  condition,  this  treat- 
ment may  not  give  permanent  relief.  In  prac- 
tically all  of  these  cases  of  stomach  headache, 
there  is  too  much  acid  in  the  stomach.  This 
can  be  readily  neutralized  by  letting  the  pa- 
tient drink  half  a  glass  of  water  containing 
half  a  teaspoonful  of  common  baking  soda.  No, 
this  is  not  medicine.  If  your  patient  spilled 
hydrochloric  acid  on  his  hands,  would  you  not 
apply  anything  you  could  get  to  neutralize  the 
acid?  Of  course,  you  would.  Then,  why  not 
neutralize  the  acid  in  the  stomach,  when  it  is 
burning  up  the  lining  of  the  stomach  and  caus- 
ing the  headache  ? 

31 


Inhibition  of  the  same  nerve  will  stop 
vomiting.  If  a  patient  gets  sick  while  riding 
on  the  cars,  this  nerve  will  be  hypersensitive 
before  he  is  sick  enough  to  vomit.  Inhibit  the 
nerve  to  stop  the  headache  and  to  stop  the 
vomiting. 

Very  often  when  a  patient  desires  to  vomit, 
it  is  best  to  let  him  do  so,  for  that  will  clean 
out  his  stomach.  Then  give  him  some  hot 
water  to  drink.  Even  if  he  throws  it  up,  it 
will  wash  the  stomach.  Give  him  more  hot 
water. 

Sometimes,  however,  it  is  desirable  to  have 
the  patient  keep  some  food  in  his  stomach. 
This  can  be  done  by  inhibiting  the  fourtti 
thoracic  nerve  the  right  hand  side.  Hold  one 
finger  on  the  nerve,  while  the  patient  eats  or 
drinks  some  liquid  food.  After  the  food  has 
been  in  the  stomach  for  a  few  minutes  the 
disturbance  calms  to  such  a  degree  that  it  is 
no  longer  necessary  to  inhibit  the  nerve. 


Plate    11— TECHXIC    FOR    STOPPING    HIC- 
COUGHS 


33 


PLATE  11— TECHNIC  FOR  STOPPING 
HICCOUGHS. 


Hiccoughs  are  due  to  spasms  of  the  dia- 
phragm, brought  about  by  inflammation  of  the 
phrenic  nerves.  This  inflammation  often 
spreads  from  the  stomach  to  the  lower  side 
of  the  diaphragm  where  the  terminal  branches 
of  the  phrenic  nerves  are  numerous. 

All  osteopaths  agree  that  the  way  to  stop 
hiccoughs  is  by  inhibiting  the  phrenic  nerves  ; 
but  they  do  not  agree  as  to  where  these  nerves 
should  be  inhibited. 

Plate  39  shows  the  thumb  on  the  right  phren- 
ic nerve  and  the  index  finger  on  the  left  one. 
The  thumb  and  finger  is  on  each  side  of  the 
trachea,  but  they  do  not  touch  the  trachea. 
The  thumb  and  finger,  after  pushing  the  ster- 
nocleido  mastoid  muscles  laterally,  pressees  the 
phrenic  nerves  against  the  anterior  side  of  the 
transverse  processes  of  the  vertebrae.  A 
steady  pressure  on  these  nerves  from  thirty 
seconds  to  two  minutes  should  stop  any  case 
of  hiccoughs,  unless  it  is  due  to  continued  use 
of  morphine  or  hiccoughs  denoting  approach- 
ing death.  Hiccoughs  due  to  use  of  morphine 
can  be  stopped,  though  sometimees  they  are 
stubborn. 

34 


After  the  hiccoughs  have  been  stopped  in 
this  manner,  treatment  should  be  given  for 
the  stomach  trouble  or  other  cause,  to  prevent 
their  return. 


Plate   12— THE  PROPER  WAY  FOR  A  PATIENT 
TO  GET  ASTRIDE  THE  TABLE 


36 


PLATE    12— THE    PROPER   WAY    FOR   A 

PATIENT  TO  GET  ASTRIDE  THE 

TABLE. 

The  patient  should  sit  on  the  table  as  shown 
in  Plate  12  ;  then  she  should  raise  her  right  foot 
and  swing  it  across  the  table  to  the  position 
shown  in  Plate  13. 


.17 


Plate  13— A  CONVENIENT  WAY  OF  THROWING 
THE  STRAP  ACROSS  THE  TABLE  AND 
BACK  UNDER  IT  TO  THE  OPERA- 
TOR'S FEET. 

38 


PLATE  13— A  CONVENIENT  WAY  OF 

THROWING  THE  STRAP  ACROSS 

THE  TABLE  AND  BACK  UNDER 

IT  TO  THE  OPERATOR'S 

FEET. 

Hold  the  strap  as  shown  in  Plate  13,,  swing 
the  buckle  out  as  far  beyond  the  table  as  is 
necessary  and,  as  it  swrings  back  toward  the* 
table,  lower  the  hand  so  that  the  buckle  will 
pass  under  the  table  and  light  near  your  feet. 
Pick  up  the  strap  and  buckle  it  firmly  across 
the  patient's  thighs,  as  shown  in  Plate  14.  The 
strap  will  hold  the  patient's  hips  firmly  on  the 
table  and  make  the  spinal  movements,  as 
shown  in  Plates  14  and  15,  more  effective. 


Plate     14— TECHNIC      FOR     TORTION     TREAT- 
MENT OF  THE   SPINAL  COLUMN 


40 


PLATE  14— TECHNIC  FORTORTION 

TREATMENT  OF  THE  SPINAL 

COLUMN. 

The  patient's  hands  are  interlocked  over  the 
back  of  her  neck.  The  operator's  right  arm 
passes  below  the  patient's  right  arm  and  his 
hand  grasps  her  left  arm  just  below  her  shoul- 
der. \Yith  this  hold,  he  turns  her  shoulders 
toward  the  right  several  times  to  produce  the 
desired  tortion  movements  of  the  spinal  col- 
umn. 

After  turning  the  patient's  shoulders  a  few 
times  toward  the  right,  as  shown  in  Plates  14, 
the  operator  changes  hands,  and  turns  her 
shoulders  toward  the  left  several  times.  By 
varying  the  flexure  of  the  spinal  column,  while 
giving  this  treatment,  desired  points  may  be 
affected. 

This  technic  is  too  well  known  to  require 
detailed  explanation,  however,  it  might  be  in 
order  to  say  that  the  main  object  is  to  relax 
the  deep  muscles  and  ligaments  along  the 
spinal  column.  This  relaxation  is  very  import- 
ant, as  it  is  the  soft  tissue  near  the  lesioned 
vertebrae  that  suffers  first  and  most  from  the 
lesion,  and  becomes  abnormally  contracted. 
Chronic  inflammatory  processes  at  the  verte- 
bral lesions  are  bound  to  cause  some  hyper- 

41 


plasia,  which  interferes  with  nerve  functioning 
and  blood  movements. 

In  many  cases,  there  are  hypertonia  of  the 
spinal  muscles  and  shortening  of  spinal  liga- 
ments without  specific  vertebral  lesions.  Such 
conditions  interfere  with  nerve  action  and 
blood  movements,  in  and  about  the  spinal 
canal,  and  are  necessarily  detrimental  to  health. 
This  spinal  treatment  is  very  beneficial,  if 
properly  given. 


42 


Plate     15— TECHNIC     FOR     GIVING     TORTION 

TREATMENT  OF  THE  SPINAL  COLUMN 

BY  HALF  NELSON  HOLD. 


43 


PLATE  15— TECHNIC  FOR  GIVING  TOR- 

TION  TREATMENT  OF  THE  SPINAL 

COLUMN  BY  HALF  NELSON 

HOLD. 

In  this  treatment,  the  operator's  right  arm 
passes  under  and  in  front  of  the  patient's 
right  arm,  and  his  hand  rests  on  the  back  of 
her  neck. 

The  patient  should  lean  forward  and  to  the 
right,  while  her  head  and  shoulders  are 
turned  toward  the  right  several  times.  This 
movement  permits  of  greater  head  and  shoul- 
der circumduction  than  the  technic  under  Plate 
14;  therefore,  it  gets  better  spinal  action.  It 
also  relaxes  some  of  the  ventral  and  lateral 
muscles  of  the  abdominal  and  chest  parites. 
The  ouadratus  lumborum,  over  the  crest  of  the 
ilium,  where  it  so  often  pulls  the  twelfth  rib 
down,  can  be  relaxed  effectively  by  this  move- 
ment. 

Try  this  movement  without  the  strap ;  then 
try  it  with  the  strap  buckled  across  the  pa- 
tient's thighs  and  note  the  difference.  You 
will  discover  that  the  strap  is  a  great  aid  and 
that  the  results  obtained,  by  treatment  with 
the  strap,  are  better  than  those  obtained  with- 
out the  use  of  it. 


44 


PLATES    16,    18,    21    AND    22— SHOWING 

HOW  THE   SHOULDER   STRAPS 

SHOULD  BE  PUT  ON  THE 

PATIENT. 

Buckle  the  ends  of  the  fourteen-foot  strap 
together.  Hook  the  snap  on  this  strap  into  the 
handle  at  the  front  of  the  tahle  ;  then  put  the 
strap  over  the  patient's  head  and  shoulders  to 
her  back  and  just  below  the  axilla,  as  shown 
in  Plate  16.  The  forty-inch  strap,  attached  to 
this  fourteen-foot  strap,  should,  be  at  the  pa- 
tient's right  and  just  in  front  of  her  axi1la,  as 
shown  in  Plate  18.  Put  this  strap  over  the  pa- 
tient's right  shoulder  and  downward  between 
the  patient's  back  and  the  fourteen-foot  strap, 
as  shown  in  Plate  21  ;  then  raise  the  free  end 
of  it  and  put  it  over  the  patient's  left  shoulder 
ar.d  buckle  it  to  the  six-inch  strap,  fastened 
on  the  fourteen-foot  strap,  as  shown  in  Plates 
•18  and  22. 

The  object  of  the  strap  over  the  patient's 
shoulders  is  to  hold  the  fourteen-foot  strap  at 
any  cbsirecl  position  on  the  patient's  back. 


45 


Plate    16— TECHNIC   FOR   TREATING   THE 
SHOULDER  AND  COSTAL  REGION. 


46 


PLATE  16— TECHNIC  FOR  TREATING 

THE  SHOULDER  AND  COSTAL 

REGION. 

Beginning-  with  the  patient  as  shown  in  Plate 
16,  take  hold  of  her  elbow  with  the  right  hand 
and  with  the  left  hand  hold  her  hand  on  top 
of  her  shoulder.  Raise  her  elbow  as  high  as 
possible  in  a  line  directly  in  front  of  her  shoul- 
der. (This  pulls  on  the  pectoralis  major  mus- 
cle, raises  the  ribs  and  relaxes  the  intercostal 
muscles.)  Raise  as  high  as  possible  and  lower 
the  elbow  a  few  times  in  this  position.  Then 
lower  it  and  swing  it  a  little  toward  the  right. 
Raise  and  lower  it  a  few  times  from  that  po-» 
sition.  Next  swing  the  elbow  out  directly 
lateral  to  the  shoulder  joint  and  raise  and 
lower  it  a  few  times  from  that  position.  Re- 
peat this  movement  with  the  elbow  thrown 
farther  backward.  Draw  the  arms  backward, 
as  shown  in  Plate  20.  Treat  the  left  shoulder 
and  costal  region  in  the  same  manner.  Finally, 
take  both  arms  and  treat  them  as  shown  in 
Plate  17. 

These  various  movements  relax  every  mus- 
cle and  ligament  about  the  shoulders,  expand 
the  chest  and  free  intercostal  circulation  and 
nerve  action.  The  technic  is  very  foreful,  yet 
it  is  easy  on  the  operator,  for  he  stands  erect 
and  works  with  a  long  leverage.  (For  other 
chest  technic,  see  Plates  28,  29  and  30.) 

47 


Plate  17— SHOULDER  TECHXIC. 


48' 


Plate    18— TECHNIC    FOR    EXPAXDIXG   THE 
CHEST. 


49 


PLATE    18— TECHNIC  FOR   EXPANDING 
THE  CHEST. 

This  treatment  is  usually  given  with  the 
operator's  knee  in  the  patient's  back,  while 
the  patient  sits  on  a  stool.  By  the  method 
shown  in  Plate  18,  the  strap  takes  the  place  of 
the  knee. 

The  patient's  arms  should  be  raised,  with 
the  elbows  close  together,  and  the  elbows, 
flexed  as  the  hands  are  lowered  directly  to  the 
shoulders. 

This  movement  is  too  well  known  to  require 
further  explanation. 


50 


Plate  19— TECHNIC  FOR  CORRECTING  A  FIRST 
RIB  LESION. 


51 


Plate  19— TECHNIC  FOR  CORRECTING  A 
FIRST  RIB  LESION. 


Dr.  Ashmore,  in  her  "Osteopathic  Mechan- 
ics," on  page  171,  says:  "Depression  lesions 
of  the  first  rib  are  rare,"  and  I  find  this  to  be 
true.  The  upward  lesion,  however,  is  fre- 
quently found.  It  may  cause  pain  at  the  head 
of  the  rib,  and  frequently  causes  pain  in  the 
arm  or  hand. 

The  strap  is  placed  under  the  right-hand 
corner  of  the  table  and  over  the  lesioned  left 
rib,  as  shown  in  Plate  19.  The  strap  over  the 
patient's  thighs  is  not  necessary  for  this  opera- 
tion. Buckle  the  strap  snugly,  but  not  very 
tightly,  over  the  uatient's  shoulder.  Have  the 
patient  lean  toward  the  left  to  tighten  the 
strap,  and  forward  to  make  the  strap  pull 
backward  and  downward.  The  downward  and 
backward  pull  corrects  the  lesion. 

Be  careful  to  have  the  strap  close  enough  to 
the  patient's  neck  to  be  on  the  first  rib. 

This  rib  technic  is  easy  en  the  operator,  easy 
on  the  patient  and  very  effective.  I  have 
never  known  it  to  fail.  I  usually  have  the 
patient  lean  forward  against  the  pull  of  the 
strap  two  or  three  times  to  make  certain  that 
the  correction  is  complete. 

52 


Before  I  learned  this  strap  method  for  cor- 
recting the  first  rib  lesion,  I  pressed  on  the 
rib  with  my  thumb,  while  I  flexed  the  patient's 
head  laterally  toward  the  lesioned  side  to 
spring  the  lirst  thoracic  vertebra  away  from 
the  head  of  the  rib.  I  learned  that  the  thumb 
pressure  often  produced  soreness.  I  have  had 
no  such  complaint  from  the  use  of  the  strap. 


Plate  20— TECHNIC  FOR  TREATMENT  OF  THE 
STERNOCLAVICULAR   ARTICULATION. 


54 


PLATE  20— TECHNIC  FOR  TREATMENT 

OF  THE  STERNO  CLAVICULAR 

ARTICULATION. 

The  operator  passes  his  right  hand  over  the 
patient's  right  shoulder  and  puts  his  thumb  an<i 
fingers  at  her  left  sternoclavicular  articulation 
to  feel  the  movements  of  the  clavicle  produced 
by  backward  and  circumduction  movements  of 
the  patient's  left  arm,  as  shown  in  Plate  20. 

By  raising  and  lowering  the  patient's  left 
arm,  while  it  is  extended  backward,  the  clav- 
icle can  be  rotated  on  its  longitudinal  axis ; 
and  by  pulling  the  patient's  arm  downward 
and  backward,  the  clavicle  can  be  drawn  from 
the  sternum,  thus  stretching  the  ligaments  of 
this  articulation. 

This  technic  is  especially  beneficial  in  the 
treatment  of  bronchitis,  asthma  or  ir  affection 
of  the  threat  and  vocal  cords  due  to  irritation 
of  the  recurrent  laryngeal  nerve.  Obstinate 
coughs,  due  to  this  irritation,  may  be  cured 
by  this  treatment. 

The  technic  gives  the  operator  such  power- 
ful leverage,  that  he  should  work  carefully 
until  he  is  quite  familiar  with  it. 


55 


Plate  21— TECHNIC  FOR  CORRECTING  AX 
ACROMIOCLAVICULAR  SUBLAXATION. 


56 


Plate     22— TECHNIC     FOR     CORRECTING     A] 
ACROMIOCLAVICULAR   SUBLUXATION. 


57 


PLATES  21  AND  22— TECHNIC  FOR  COR- 
RECTING AN  ACROMIO  CLAVI- 
CULAR SUBLUXATION. 

The  usual  subluxation  of  this  articulation  is 
an  upward  or  upward  and  forward  one  of  the 
clavicle. 

To  test  for  this  subluxation,  raise  the  pa- 
tient's elbow  laterally  from  the  body.  If  the 
lesion  is  present,  he  cannot  raise  the  elbow  in 
that  direction  high  enough  to  put  his  hand  on 
top  of  his  head,  neither  can  the  operator  do  it 
for  him. 

This  movement  may  be  impossible  also,  in 
case  of  soreness  in  and  about  the  shoulder 
joint  from  rheumatism,  neuritis,  or  synovitis, 
or  in  case  of  anklyosis ;  but,  these  conditions 
can  be  readily  differentiated  by  any  osteo- 
path. 

The  ligaments  of  this  articulation,  to  be 
taken  into  consideration,  are  the  superior 
acromio  clavicular  and  the  inferior  acromio 
clavicular. 

When  the  acromium  is  drawn  from  the  end 
of  the  clavicle,  the  ligaments,  if  normal,  guide 
the  clavicle  to  its  proper  place ;  so,  when  the 
acromium  is  allowed  to  return,  the  articular 
surfaces  naturally  meet  in  proper  relation  to 
each  other. 

The  treatment  is  given  as  shown  in  Plate  21 . 
58 


The  palm  of  the  patient's  hand  is  turned  out- 
ward to  stiffen  the  elbow  joint ;  then  the  pa- 
tient's arm  is  drawn  downward  and  backward 
so  the  humerus  pries  across  the  ribs  and  forces 
the  acromium  away  from  the  clavicle.  When 
the  patient's  arm  is  released,  the  lesioned  ar- 
ticular surfaces  should  come  together  in  proper 
relation.  Test  it  by  raising  the  arm,  with  the 
elbow  laterally  to  the  shoulder.  When  the 
articulation  is  correct,  it  will  go  up  with  ease. 

In  some  cases  the  operator  will  find  it  neces- 
sary to  press  downward  and  backward  on  the 
end  of  the  clavicle,  while  the  articulation  is 
being  separated  by  the  arm  movement  as 
above  described. 

If  hyperplastic  tissue  has  been  formed  by 
long  standing  irritation  and  inflammation  it 
this  articulation,  or  exostosis  has  developed, 
more  force  is  required  than  above  described. 
In  that  event,  use  the  method  shown  in  Plate 
22,  in  which  a  strap  is  passed  under  one  cor- 
ner of  the  table  and  over  the  patient's  shoul- 
der to  hold  down  the  end  of  the  clavicle  ;  then 
raise  the  patient's  elbow,  as  shown  in  Plate  22, 
to  raise  the  acromial  process. 

This  is  a  powerful  treatment  and  it  should 
be  handled  carefully,  as  the  end  of  the  clavicle 
might  be  forced  too  far  downward. 

In  some  cases  the  diseased  process  may  have 
made  complete  correction  impossible  without 

59 


several  treatments.  In  such  cases,  after  giv- 
ing the  treatment,  raise  the  patient's  elbow 
laterally  to  the  body  and  see  if  it  goes  higher 
than  it  did  before  treatment.  If  it  does,  some 
progress  has  been  made.  If  the  patient's  hand 
goes  up  to  the  top  of  his  head,  with  the  elbow 
raised  laterally  from  the  shoulder,  the  reduc- 
tion is  complete. 

There  is  no  other  joint  in  the  body  so  diffi- 
cult to  keen  in  proper  place  after  it  has  beep 
lesioned.  It  is  well  to  warn  the  patient  that 
it  may  be  necessary  to  correct  this  lesion  sev- 
eral times  before  it  will  stay  corrected. 

Sleeping  on  the  affected  side  often  produces 
this  subluxation,  especially  if  a  small  pillow  is 
used  under  the  head,  as  that  puts  more  weight 
on  the  shoulder.  Throwing  a  ball,  or  other 
object,  may  produce  such  a  subluxation.  Gym- 
nasium work  is  likely  to  produce  it. 

Such  a  subluxation  usually  causes  pain  in  the 
shoulder  and  arm,  especially  at  the  deltoid  in- 
sertion on  the  humerus.  This  pain  will  usually 
leave  at  once  on  reduction  of  the  subluxation. 

In  many  cases  the  patient  can  correct  his 
acromioclavicular  subluxation  by  turning  his 
palm  outward  and  forcibly  swinging  his  arm 
backward  to  the  position  shown  in  Plate  21. 
In  this  manner  the  patient  accomplishes  the 
same  results,  as  the  operator  does  for  him, 
as  shown  in  Plate  21. 

60 


Plate  23— TECHXIC  FOR  TREATING  THE  UPPER 
DORSAL  AND  CERVICAL  VERTREBRAE. 


61 


PLATE  23.— TECHNIC  FOR  TREATING 
THE  UPPER  DORSAL  AND  CERVI- 
CAL VERTEBRAE. 

With  the  patient  as  shown  in  Plate  23,  place 
one  hand  on  top  of  her  head  to  move  her  head 
as  desired.  The  other  hand  is  used  to'  make 
fixation  at  the  proper  vertebra. 

This  position  permits  freely  of  anterior,  pos- 
terior, lateral  and  circumduction  movements 
of  the  head.  Any  desired  movement  of  the 
vertebrae  can  be  secured  and  the  adjustment 
is  comparatively  easy  to  make. 

In  order  to  get  the  most  favorable  move- 
ments of  the  upper  dorsal  vertebrae,  turn  the 
patient's  face  somewhat  laterally  to  stiffen  the 
neck,  and  then  make  forward  and  backward 
movements  as  desired.  In  that  manner  move- 
ments of  the  first,  second,  or  third  dorsal  ver- 
tebra can  be  produced  readily ;  and,  if  the  pa- 
tient is  slim,  good  movements  can  be  obtained 
on  the  fourth  dorsal  vertebra. 

Many  operators  work  on  these  cervical  and 
dorsal  vertebrae  while  the  patient  is  lying 
down ;  but  I  have  never  been  able  to  get  the 
desired  movements,  with  the  patient  lying  on 
the  table,  as  well  as  I  can  get  them  with  the 

62 


patient  sitting  up,  her  shoulders  held  by  the 
strap,  as  shown  in  Plate  23. 

Another  point  of  advantage  is,  that  the 
operator  stands  erect,  instead  of  stooping  over 
a  table  and  tiring  his  back  while  making  the 
corrections. 


63 


Plate  24— TECHNIC   FOR  CORRECTING  A   POS- 
TERIOR    OCCIPUT. 


64 


PLATE  24,— TECHNIC  FOR  CORRECTING 
A  POSTERIOR  OCCIPUT. 

The  patient  is  pulling  backward  on  the  strap 
as  shown  in  this  plate.  The  occiput  cannot  go 
backward,  on  account  of  the  strap ;  but  the 
cervical  vertebrae  will,  move  backward  as  the 
muscles  of  the  neck  pull  on  them. 

The  patient  should  raise  and  lower  her  chin, 
in  various  positions,  and  pull  again,  to  permit 
movement  of  the  occiput  on  the  atlas.  An 
osteopath  can  correct  his  own  posterior  occiput 
by  this  technic. 

The  posterior  occipital  lesion  is  a  very  com- 
mon one.  It  forces  the  transverse  processes 
of  the  upper  cervical  vertebrae  against  the 
superior  cervical  ganglion  and  irritates  it  so 
as  to  cause  trouble  in  the  throat,  ear  or  cer- 
ebral meninges.  For  more  on  this  subject  and 
on  this  lesson,  see  plate  25  and  its  explanation. 


65 


Plate  25— TECHNIC  FOR  TREATING  THE  NECK 
WITH  CHEST  STRAPPED. 


66 


PLATE  25.— TECHNIC  FOR  TREATING 
THE  NECK  WITH  CHEST  STRAPPED. 

In  this  plate,  there  is  but  one  strap  used,  and 
that  is  placed  across  the  patient's  shoulders 
and  chest.  It  should  be  buckled  snugly,  but 
not  tightly  enough  to  be  uncomfortable  for  the 
patient. 

In  order  to  crack  the  joints  of  the  neck,  take 
hold  the  patient  as  shown  in  the  plate,  but 
do  not  raise  her  head  from  the  pillow.  Turn 
the  patient's  head  to  the  right  or  left,  as  de- 
sired, and  wait  until  the  neck  muscles  are 
properly  relaxed.  Give  a  quick  turn  of  the 
head  and  note  how  easy  it  is  to  make  the 
joints  crack.  Usually  two  or  three  pounds' 
force  is  all  that  is  necessary  to  make  the  joints 
pop. 

The  strap  is  especially  beneficial  in  treating 
a  posterior  occiput.  As  shown  in  the  plate,  the 
head  should  be  raised  so  that  the  neck  is  at 
an  angle  of  about  45  degree.  While  the  head 
is  so  raised,  give  extension  and  slight  lateral 
rotation.  This  movement  not  only  stretches 
the  ligaments  of  the  neck,  but  it  moves  the 
head  forward  on  the  atlas.  Special  effort 
should  be  made  to  have  the  patient  relax  the 
muscles  of  the  back  of  the  neck. 

My  experience  has  led  me  to  believe  that 
the  posterior  occiput  is  the  most  common 

67 


lesion  of  the  neck  and  it  is  especially  produc- 
tive of  trouble  in  the  ear,  throat,  tonsils  and 
cerebral  meninges.  I  have  never  treated  a 
case  of  otitis  media  that  was  not  due  to  a 
posterior  occiput.  This  lesion  forces  the 
transverse  processes  of  the  upper  cervical  ver- 
tebrae against  the  superior  cervical  ganglion, 
causing  irritation  which  incapacitates  these 
nerves  for  normal  functioning.  All  branches 
from  the  superior  cervical  ganglion  are  af- 
fected by  irritation  of  this  ganglion. 

I  have  treated  children,  partially  paralyzed 
in  the  throat  and  all,  the  exteremities  by  a  pos- 
terior occiput  evidently  produced  at  birth. 

In  case  of  a  posterior  occiput,  the  upper  end 
of  the  ligamentum  nuchea  is  moved  backwards 
with  the  occiput  and  it  will  be  farther  away 
from  the  spinus  process  of  the  second  cervical 
vertebra  than  it  would  be  in  normal  conditions. 
To  test  for  this  condition,  while  the  patient  lies 
on  her  back,  raise  her  head  to  tighten  the 
ligamentum  nuchea  and  press  on  the  ligament, 
near  its  upper  end,  to  see  if  it  springs  against 
the  spinus  process  of  the  vertebra.  If  it 
springs,  there  is  a  posterior  occiput.  In  nor- 
mal conditions,  the  ligament  is  against  the 
spinus  process  of  the  vertebra,  and  there  is  no 
spring  to  it.  Give  the  treatment  as  above  de- 
scribed and  test  again.  If  the  ligament  then 
lies  against  the  spinus  process,  the  lesion  has 

68 


been  corrected.  If  an  operator  is  not  familiar 
with  this  test,  he  may  lack  confidence  in  it, 
and  he  should  palpate  the  transverse  processes 
of  the  atlas  to  satisfy  himself  of  his  diagnosis. 
In  many  cases,  I  have  found  it  difficult  to  pal- 
pate the  transverse  processes,  so  I  have  exam- 
ined, i  n  a  few  seconds,  by  the  ligamentum 
nuchea. 

When  the  strap  is  not  used  for  this  treat- 
ment, the  patient  usually  raises  one  or  both 
shoulders  and  tightens  the  cervical  muscles. 
Relaxation  of  the  cervical  muscles  is  much  bet- 
ter when  the  strap  is  used,  the  treatment 
is  more  effective,  especially  when  an  upward 
pull  is  desired  for  correcting  a  posterior  occi- 
put or  for  stretching  the  posterior  ligaments 
and  muscles  of  the  neck. 


69 


Plate  26— TECHNIC  FOR  TREATING  THE  NECK 
WITH  CHEST  AND  FEET  STRAPPED. 


70 


PLATE  26.— TECHNIC  FOR  TREATING 

THE  NECK  WITH  CHEST  AND 

FEET  STRAPPED. 

In  this  treatment,  there  are  two  straps  used, 
one  as  shown  in  Plate  25,  over  the  patient's 
shoulders  and  chest,  the  other  around  the  tabu; 
and  around  both  feet.  The  strap  at  the  pa- 
tient's feet  prevents  the  body  from  sliding  tj- 
wards  the  foot  of  the  table  when  pressure  is 
applied  to  the  top  of  her  head. 

In  giving  this  treatment,  the  operator  places 
the  pillow  "between  his  body  and  the  patient's 
head  to  enable  him  to  push  easily  on  top  of 
her  head.  While  pressure  is  applied  to  the  top 
of  the  head,  the  operator  can  give  any  move- 
ment he  desires  to  head  and  neck.  He  can 
raise  and  lower  the  base  of  the  skull  to  get 
good  movements  at  the  atlanto-occipital  ar- 
ticulation. He  may  give  lateral  movements 
of  the  neck  and,  by  moving  his  body  to  the 
right  or  left,  may  swing  the  patient's  head 
to  get  any  desired  lateral  movemet  of  the 
neck. 

By  the  aid  of  these  movements  and  the  use 
of  the  hands,  as  shown  in  Plate  26,  corrective 
work  can  be  accomplished  of  lesions  of  the 
upper  cervical  vertebrae. 

By  use  of  these  straps,  excellent  relaxation 
71 


of  the  patient's  cervical  muscles  can  be  se- 
cured; and  the  treatment,  if  properly  given, 
will  be  very  effective. 


72 


Plate  27— TECHNIC  FOR  ROTATING  THE  LUM- 
BAR AND  LOWER  DORSAL  REGION. 


73 


PLATE    27.— TECHNIC    FOR    ROTATING 

THE  LUMBAR  AND  LOWER  DORSAL 

REGION. 

The  strap  extends  around  the  table  and  over 
the  patient's  hips.  It  is  tightly  drawn  and 
buckled  to  prevent  her  hips  from  rotating.  If 
the  upper  hip  is  directly  over  the  lower  one. 
the  strap  will  not  hold  it  firmly.  The  patient 
must  lie  in  such  position  that  the  upper  hip  is 
farther  forward  than  the  lower,  before  the 
strap  is  tightened. 

The  operator  holds  one  hand  on  the  lumbar 
region  to  note  the  spinal  movements,  as  he 
pushes  the  patient's  shoulder  backward  with 
the  other  hand.  The  patient's  shoulder  should 
be  pushed  back  and  forth  several  times  lo 
loosen  the  lumbar  muscles  and  ligaments. 

To  reach  the  fifth  lumbar  by  this  method, 
place  the  patient's  head  and  shoulders  back 
farther  on  the  table,  and  rotate  the  spinal  col- 
umn as  shown  in  Plate  27 ;  also,  put  one  elbow 
and  forearm  on  the  patient's  hip  and  force  it 
downward  suddenly  to  rotate  the  pelvis  for- 
wards, when  the  patient's  shoulder  is  rotated 
backward  as  far  as  possible.  This  act  usually 
elicits  from  one  to  half  a  dozen  "pops"  of  the 
joints  in  the  lumbar  region. 

When  the  movement  is  desired  especially  in 

74 


the  upper  lumbar  and  lower  dorsal  regions, 
slide  the  patient's  head  and  shoulders  forward 
on  the  table,  before  rotating  the  spinal  column 
as  shown  in  Plate  27. 

The  direction  of  the  force  applied  by  the 
operator  on  the  patient's  shoulder  determines 
where  the  greatest  spinal  movement  takes 
place.  If  the  operator  stands  near  the  head  of 
the  table  and  pushes  on  the  patient's  shoulder, 
the  force  will  be  centered  in  the  lower  lumbar 
region. 

After  treating  one  side  as  above  explained, 
the  patient  should  turn  over  and  have  the 
other  side  treated  in  like  manner. 

This  treatment  is  a  continuation  of  the  spinal 
rotation  treatment  begun  in  Plates  14  and  15 
with  the  patient  sitting  on  the  end  of  the 
table. 


75 


Plate    28— TECHNIC    FOR    RAISING    THE    RIBS, 

AND  RELAXING  THE  INTERCOSTAL 

MUSCLES. 


76 


PLATE  28.— TECHNIC  FOR  RAISING  THE 
RIBS  AND  RELAXING  THE  INTER- 
COSTAL MUSCLES. 

See  Plate  28  and  note  that  the  patient  is  in 
the  same  position  as  shown  in  Plate  27  for  ro- 
tation of  the  spinal  column.  The  strap  holds 
the  hips  firm,  while  the  arm  is  used  as  a  lever 
to  raise  the  ribs  and  stretch  the  intercostal 
muscles. 

As  in  Plate  16,  the  arm  should  be  raised  from 
different  positions  to  pull  on  different  muscl.es. 
If  the  operator  wishes,  he  can  assist  in  stretch- 
ing the  intercostal  muscles  by  pressing  dowr> 
ward  on  the  ribs,  while  the  patient's  elbow  is 
raised  and  pulling  upward  on  them. 

This  is  another  powerful  treatment,  which 
should  be  handled  carefully  until  the  operator 
is  familiar  with  it. 

The  value  of  this  treatment  can  be  better 
understood  by  thinking  over  the  various  ail- 
ments that  are  the  result  of  contractions  about 
the  chest  such  as  intercostal  neuralgia,  heart 
trouble,  etc.,  as  well  as  anemic  conditions  due 
to  interference  with  the  normal  circulation  of 
blood,  into  ;ind  out  of  the  ribs,  where  millions 
of  blood  cells  should  be  manufactured  and  put 
into  the  general  circulation. 

77 


After  being  treated  on  one  side,  as  above 
explained,  the  patient  should  turn  over  and 
have  the  other  side  treated  in  the  same  man- 
ner. 

This  method  of  treatment  is  very  -effective 
for  raising  a  depressed  fourth  or  fifth  ri'), 
which  may  be  the  cause  of  chronic  heart  trou- 
ble. 


78 


Plate  29— TECHNIC  FOR  TREATING  THE 

SHOULDER   AND    PECTORAL 

MUSCLES. 

79 


PLATE    29.— TECHNIC    FOR    TREATING 

THE  SHOULDER  AND  PECTORAL 

MUSCLES. 

This  treatment  is  a  continuation  of  the  work 
started  in  Plates  17  and  28.  The  same  explana- 
tion applies  here  as  was  given  under  those 
plates. 


Plate  30— TECHXIC  FOR  TREATING  THE  RIBS 
AND  SPIXAL  COLUMN. 


PLATE    30.— TECHNIC    FOR    TREATING 
RIBS  AND  SPINAL  COLUMN. 

As  shown  in  this  plate,  the  patient's  hand  is 
en  the  back  of  her  head,  while  force  is  applied 
to  her  elbow  to  throw  her  shoulder  backward 
and  to  rotate  the  spinal  column.  While  the 
patient's  shoulder  is  forced  backward,  her 
ribs  are  drawn  forward  by  the  operator  ;  or  the 
operator  may  stand  behind  the  patient  and 
push  on  the  ribs,  while  he  pulls  backward  on 
the  elbow. 

This  movement  can  be  used  for  correcting 
lesioned  ribs  or  for  expanding;  the  chest  and 
relaxing  the  intercostal  muscles. 


82 


Plate  31— TECHNIC  FOR  TREATING  ELEVENTH 
OR  TWELFTH  RIB  LESIONS. 


83 


PLATE    31.— TECHNIC    FOR    TREATING 

ELEVENTH  OR  TWELFTH  RIB 

LESIONS. 

These  cases,  which  are  very  common,  usu- 
ally reach  an  osteopath,  since  the  medical,  doc- 
tors fail,  to  diagnose  or  treat  them  correctly. 

I  treated  one  case  of  over  ten  years'  stand- 
ing. Several  medical  doctors  had  treated  the 
case,  and  when  they  insisted  on  operating  to 
find  the  cause  of  the  pain,  the  patient  came 
to  me  for  examination  and  treatment.  That 
was  about  three  years  ago.  The  patient 
weighed  114  pounds.  I  corrected  this  rib  lesion 
and  cured  the  trouble.  The  patient  now  weighs 
150  pounds  and  is  in  the  best  of  health. 

The  usual  cause  of  this  lesion  is  a  contrac- 
tion of  the  quadratus  lumborum  muscle,  which 
draw  the  anterior  end  of  the  twelfth  rib  down- 
wards and  causes  it  to  irritate  the  soft  tissues. 
Sometimes  the  transverse  abdominal  muscles 
are  also  at  fault. 

In  some  cases,  the  pain  remains  almost  con- 
stant ;  in  others  it  comes  on  suddenly  and  is 
severe ;  it  lasts  a  few  hours  or  a  few  days, 
when  it  gradually  disappears. 

The  irritation  is  usually  at  the  end  of  the 
rib ;  but  the  pain  that  the  patient  complains 

84 


of  is  usually  in  the  abdomen.  The  patient  does 
not  suspect  that  the  trouble  is  at  the  rib, 
though,  sometimes,  the  pain  is  severe  enough 
to  cause  a  fever. 

On  examination,  the  patient  recognizes  the 
hypersensitiveness  at  the  anterior  end  of  the 
rib,  as  soon  as  the  examiner's  finger  presses 
gently  at  that  point.  In  some  cases,  the  rib  is 
drawn  down  far  enough  to  irritate  the  soft 
tissue  at  the  crest  of  the  ilium  and  cause  it  to 
become  hypersensitive.  In  this  class  of  cases, 
the  only  pain  may  be  between  the  end  of  the 
rib  and  the  crest  of  the  ilium. 

As  shown  in  Plate  31,  the  patient's  upper  hip 
is  directly  over  the  lower  one  and  firmly  held 
by  the  strap.  The  operator  puts  his  elbow  in 
front  of  the  patient's  arm  and  shoulder  to 
press  them  backward,  while,  with  both  hands, 
he  pulls  upward  and  forward  on  the  lower  ribs 
and  the  quadratus  lumborum  muscles.  The 
strap  holds  the  hip  so  firmly  that  the  operator 
can  exert  a  very  strong  pull,  in  this  manner, 
on  the  quadratus  lumborum  muscle. 

If  there  is  a  considerable  hypersensitiveness 
at  or  near  the  tip  of  the  rib,  or  where  the  rib 
irritates  the  crest  of  the  ilium,  let  the  patient 
lie  on  her  back  and  buckle  the  strap  firmly 
over  the  hips,  then,  while  sitting  on  a  stool, 
reach  across  the  patient's  body  and  pull  on  the 
quadratus  lumborum  muscle. 

85 


In  this  manner,  the  operator  can  work 
around  the  sore  spots  without  producing  much 
pain.  The  pull  on  these  muscles  should  be 
upward  and  forward.  With  the  patient  lying 
on  her  back,  the  muscles  may  be  worked  with 
either  hand  or  with  both  hands,  as  the  operator 
may  wish.  The  operator  can  do  this  work 
standing;  but  he  can  do  it  more  effectively 
sitting.  Try  it  and  note  the  direction  of  the 
pull. 

For  another  way  of  treating  these  muscles, 
see  Plate  37:  This  is  a  forceful  treatment,  best 
used  after  the  greater  part  of  the  soreness  has 
been  worked  out  by  the  treatment  described 
above. 

Any  osteopath  should  be  able  to  cure  these 
cases. 


86 


Plate   32— TECHXIC   FOR   RELAXING   THE 
QUADRICEPS    EXTENSOR    MUSCLES. 


87 


PLATE  32.— TECHNIC  FOR  RELAXING 

THE  QUADRICEPS  EXTENSOR 

MUSCLES. 

The  strap  is  buckled  snugly  over  the  pa- 
tient's hips  to  keep  them  down.  The  operator 
raises  the  patient's  foot,  as  shown  in  this  plate, 
and  forces  it  to  the  hip,  or  as  near  it  as  the 
patient  will  permit.  This  produces  a  forceful 
stretch  on  the  quadriceps  extensors.  The 
operator  then  lets  that  foot  down  and  raises 
the  other  in  like  manner.  It  is  well  to  treat 
both  legs  alternately  three  or  four  times.  It 
is  advisable,  after  the  heel  touches  the  hip 
readily,  to  move  the  foot  laterally,  six  or  eight 
inches,  on  the  patient's  hip  to  put  special  strain 
on  the  vastus  internus  and  externus  muscles. 

This  treatment  frees  the  arterial  and  venous 
circulation  of  the  legs  ;  hence,  it  is  beneficial  in 
any  case  of  impeded  circulation  of  the  legs  and 
feet.  Such  cases  are  very  numerous. 

This  treatment  also  permits  the  patient  to 
raise  his  knees  freely;  thus,  it  aids  him  in 
walking.  When  these  quadriceps  extensors 
are  shortened,  they  shorten  and  retard  each 
step.  Patients  often  remark  that,  after  taking 
this  treatment,  they  find  themselves  walking 
faster  than  .usual  without  extra  effort. 

If,  by  this  treatment,  the  cmardriceps  exten- 
sors are  found  to  be  abnormally  shortened,  the 


second,  third  and  fourth  lumbar  vertebrae 
should  be  treated  to  remove  the  irritation,  at 
that  point,  from  the  anterior  crural  nerve, 
which  supplies  these  muscles. 

Very  often  these  muscles  are  contracted  .n 
one  thigh,  while  they  are  normal  in  the  other. 
The  spinal  treatment  should  be  given  accord- 
ingly. 

If  the  operator  desires  to  stretch  the  exten- 
sors of  the  foot,  he  can  extend  the  patient's 
foot,  by  pulling  gently  on  the  toe  portion  of 
the  shoe,  while  the  heel  of  the  shoe  is  near  the 
patient's  hip. 

When  the  quadriceps  extensors  are  stretched 
in  this  manner,  it  may  be  discovered  that  they 
are  hypersensitive  and  the  operation  quite 
painful.  The  operator  should  work  gently,  un- 
til he  learns  the  condition  of  these  muscles. 


Plate  33— TECHNIC  FOR  TREATING  THE  SPINAL 
MUSCLES. 


90 


PLATE    33.— TECHNIC     FOR    TREATING 
THE  SPINAL  MUSCLES. 

The  strap  is  buckled  snugly  over  the  pa- 
tient's hips  to  hold  the  body  firmly  and  pre- 
vent longitudinal  movement.  While  the  body 
is  so  anchored,  deep  treatment  of  the  spinal 
muscles  can  be  effectively  given.  Of  course, 
this  treatment  can  be  given  without  anchoring 
the  body  ;  but.  in  that  event,  there  is  a  con- 
siderable waste  energy,  as  the  patient's  body 
moves  with  each  forceable  upward  or  upward 
and  outward  movement. 

If  it  is  desired  to  treat  these  muscles  while 
they  are  in  a  fully  relaxed  condition,  it  should 
be  done  with  the  patient  lying  on  her  side.  In 
that  manner  of  working,  the  operator's  force 
is  usually  exerted  principally  outward  from  the 
spinal  column.  "When  the  muscles  are  treated 
as  shown  in  Plate  33.  the  force  is  exerted  prin- 
cipally upward,  i.  e.,  toward  the  patient's  head. 
If  a  thorough  loosening  of  the  spinal  muscles 
is  desired,  they  should  be  treated  with  the  pa- 
tient first  iu  one  position,  then  in  the  other. 


91 


Plate  34— TECHNIC  FOR  TREATING  THE  HIP- 
JOINT  AND  MUSCLES  OF  THAT  REGION. 


PLATE    34.— TECHNIC    FOR    TREATING 

THE  HIP  JOINT  AND  MUSCLES  OF 

THAT  REGION. 

In  this  treatment  there  is  but  one  strap 
used.  It  is  placed  around  the  table  and  over 
the  patient's  thigh  just  above  the  knee.  The 
strap  holds  the  right  pelvis  firmly  on  the  table 
and  permits  of  but  little  movement  of  the  left 
pelvis. 

This  treatment  is  especially  beneficial  in  the 
treatment  of  fibrous  ankylosis  of  the  hip-joint. 
It  is  a  forceful  treatment  for  such  cases.  The 
foot  may  be  raised  or  swung  laterally  as  de- 
sired and  a  powerful  strain  can  be  put  on  the 
ankylosing  fibers. 

Treatment  of  this  kind  can  be  given  to  re- 
lax the  perioneal  muscles  and  the  various 
groups  of  muscles  passing  from  the  sacrum 
and  innominate  bone  to  the  femur.  The  lev- 
erage is  great  and  the  operator  should  work 
carefully  until  he  learns  how  much  force  the 
patient  is  willing  to  tolerate. 


Plate  35— TECHNIC  FOR  TREATING  A  KNEE. 


94 


PLATE  35.— TECHNIC  FOR  TREATING  A 
KNEE. 

In  this  treatment,  a  short  strap  is  put  around 
the  patient's  thigh  just  above  her  knee,  and  a 
strap  is  attached  to  this  strap  and  to  the 
handle  at  the  head  of  the  table.  The  operator 
grasps  the  patient's  knee  with  one  hand  and 
her  foot  with  the  other  hand,  as  shown  in  this 
plate.  In  this  manner,  any  desired  movement 
can  be  produced  at  the  knee.  By  the  foothold, 
the  leg  can  be  rotated  on  its  longitudinal  axis 
and  can  be  raised,  lowered  or  given  lateral 
motion  to  suit  the  operator. 

This  treatment  is  good  for  correcting  a  slip- 
ped semilunar  cartilage,  or  for  treating  a  fib- 
rous ankylosis.  It  is  not  advisable  to  use  this 
method  for  treating  synovitis  of  the  knee- 
joint,  as  such  cases  get  along  better  if  the  knee 
is  left  alone.  They  are  sometimes  due  to  trau- 
matism,  but  more  often  due  to  an  innominate 
lesion  or  a  lesion  in  the  lumbar  region  affect- 
ing the  anterior  crural  nerve.  For  best  re- 
sults, treat  the  lesions  and  leave  the  knee  alone. 


95 


Plate  36— TECHNIC  FOR  TREATING  A  FOOT. 


96 


PLATE  36.— TECHNIC  FOR  TREATING  A 
FOOT. 

In  this  treatment  one  strap  is  put  twice 
around  the  patient's  ankle  and  another,  from 
that  strap  to  the  handle  at  the  head  of  the 
table.  Any  manipulative  foot  treatment  can 
be  given  easily  while  the  foot  is  strapped  up 
as  shown  in  this  cut ;  such  as.  treatment  fo* 
broken  arches,  for  ankylosis  following  inflam- 
matory processes,  or  for  bony  lesions. 


97 


Plate  37— TECHNIC  FOR  A  POWERFUL  LUMBAR 
TREATMENT. 


PLATE  37.— TECHNIC  FOR  A  POWERFUL 
LUMBAR  TREATMENT. 

Place  two  ordinary  pillows  or  one  large  one 
on  the  table  and  let  the  patient  lie  face  down 
across  them.  Put  one  strap  over  her  shoulders 
to  prevent  them  from  moving  sideways  on  the 
table.  Put  a  strap  across  her  lumbar  region 
at.  any  desired  place  for  a  fixed  point.  Fold 
a  towel  and  put  it  under  this  strap  to  protect 
her  back,  as  there  will  be  some  friction  there. 
Put  a  shore  strap  around  the  patient's  legs 
just  below  the  knees  to  hold  the  knees  to- 
gether. Put  a  strap  around  the  feet  to  hold 
the  feet  together.  Put  a  long  strap  under  thr 
patient's  hips,  leaving  the  buckle  hanging  about 
four  inches  below  the  top  of  the  table,  at  the 
patient's  right-hand  side.  Take  the  other  end 
of  this  strap  and  put  it  between  the  soles  of 
the  shoes  and  the  strap  around  the  feet.  Draw 
t!:is  strap  through  and  put  the  end  once  more 
under  the  strap  that -holds  the  feet  together. 
By  putting  it  twice  under  that  strap,  there  will 
be  no  slipping  of  this  long  strap,  on  the  short 
strap  that  binds  the  feet  together.  Bring  the 
free  end  of  the  long  strap  down  to  the  table 
at  the  patient's  right  side,  and  push  it  under 
the  patient's  hips,  so  that  the  free  end  will  be 
on  the  patient's  left  side.  Now  stand  even 
with  the  patient's  knees,  with  your  left  side 
to  the  table.  Put  your  left  arm  and  shoulder 

99 


against  the  patient's  feet,  while  h.er  knees  are 
flexed,  to  press  them  towards  her  hips.  While 
the  feet  are  so  pressed  down,  grasp  the  buckle- 
end  of  the  long  strap  with  your  right  hand  and 
the  tip-end  of  the  same  strap  with  your  left 
hand,  and  pull  on  both  ends  of  the  strap  to 
take  up  all  the  slack.  Then  bring  the  two  ends 
together  and  buckle  them  over  the  patient's 
hips.  This  strap  will  not  slip  on  the  hips  if 
properly  put  on.  Now  everything  is  prepared 
for  the  treatment.  All  of  these  straps  can  be 
put  on  in  two  or  three  minutes  by  an  operator 
who  is  accustomed  to  using  such  harness. 

This  harness  forces  the  pelvic  girdle  and 
the  limbs  to  move  as  a  unit.  By  rocking  the 
rpelvis,  the  movements  are  made  in  the  lumbar 
region  below  the  strap  that  has  the  folded 
towel  under  it.  The  pelvis  can  be  easily  rocked 
back  and  forth  by  pushing  on  the  patient's  feet. 
If  the  patient's  knees  are  drawn  closer  to  the 
operator,  both  extension  and  rotation  car  !)*» 
had  in  .the  lumbar  region,  by  pushing  on  her 
feet.  After  rotating  the  spine  one  way  a  few 
times,  the  operator  should  stand  on  the  op- 
posite side  of  the  table  and  rotate  the  spine 
the  other  way  a  few  times.  This  is  probably 
the  most  powerful  lumbar  treatment  known, 
yet  there  is  no  danger  of  injuring  the  patient, 
if  the  operator  uses  ordinary  judgment. 


100 


Plate  38--TECHNIC  FOR  LUMBAR  TREATMENT. 
(Continued) 


101 


PLATE      38.— TECHNIC      FOR      LUMBAR 
TREATMENT  (Continued). 

This  is  the  same  harness  described  in  Plate 
36.  After  giving  the  treatment  described  under 
Plate  36,  the  operator  pulls  on  the  patient's  feet 
and  tips  the  pelvis  towards  himself.  This  ap- 
proximates the  spinus  processes  and  stretches 
the  psoas  muscles  and  the  anterior  common 
ligament.  This  treatment  is  not  so  hard  on 
the  patient  as  one  might  imagine  from  the  pic- 
ture. The  operator  should  give  this  treatment 
from  both  sides  of  the  table  to  serve  both  side^ 
of  the  patient  alike.  By  changing  the  posi- 
tion of  the  patient's  kneees  laterally  on  the 
table,  the  operator  can  make  many  changes  in 
his  procedure.  By  adjusting  the  strap  across 
the  lumbar  region,  the  fixed  pm'nt  can  be 
placed  wherever  he  chooses. 

These  lumbar  treatments  are  especially  valu- 
able for  rigid  lumbar  spines  and  for  loosening 
and  correcting  lumbar  lesions  of  long  standing. 
If  this  treatment  fails  to  correct  such  lesions. 
they  are  not  correctable. 

The  force  exerted  at  the  first  treatment 
should  be  moderate.  Each  succeeding  treat- 
ment can  be  given  with  increasing  force.  After 
the  patient  has  had  three  or  four  such  treat- 
ments, he  can  stand  a  strong  treatment  with 
pleasure  and  without  bad  effects. 


102 


Plate    39— TECHXIC    FOR    TREATING    THE    AB- 
DOMINAL AND  QUADRATUS  LUMBORUM 
MUSCLES. 


PLATE     39— TECHNIC     FOR     TREATING 

THE  ABDOMINAL  AND  QUADRATUS 

LUMBORUM  MUSCLES. 

This  is  the  same  harness  shown  in  Plates  37 
and  38.  The  operator  takes  hold  of  the  strap, 
that  holds  the  patient's  knees  together,  and 
uses  it  as  a  handle  to  lift  the  knees  and  swing 
them  laterally.  If  the  patient's  knees  are  raised 
from  two  to  four  inches  and  carried  laterally, 
a  powerful  pull  will,  be  placed  on  the  quad- 
ratus  lumborum  muscle  near  the  side  of  the 
body,  where  it  so  often  contracts  and  draws 
the  twelfth  rib  down  to  cause  trouble.  If  the 
knees  are  raised  higher,  more  force  will  be 
exerted  on  the  abdominal  muscles. 


l.M 


Plate  40— TECHNIC  FOR  TREATING  A  LATERAL 
SPINAL     CURVATURE. 


105 


PLATE  40— TECHNIC  FOR  TREATING  A 
LATERAL  SPINAL  CURVATURE. 

A  strap  is  laid  across  the  table  with  the 
buckle  near  the  operator,  while  the  tip-end  o» 
it  is  put  through  the  handle  on  the  side  of  the 
table  as  shown  in  this  cut.  A  pillow  is  laid 
on  top  of  the  strap.  The  patient  lies  face 
down  across  the  pillow.  The  strap,  buckled 
across  her  back,  does  not  extend  around  the 
table,  but  goes  down  through  the  handle  at 
the  side  of  the  table,  and  up  over  the  patient 
The  pillow  should  be  adjusted  to  protect  thA 
patient's  right  side  from  the  strap. 

The  strap,  over  the  patient's  shoulders,  is 
through  the  handle  at  the  right-hand  side  of 
the  table.  The  operator  draws  the  patient's 
legs  towards  him  and  so  straightens  the  pa- 
tient's spine.  This  treatment  thorough!'.' 
stretches  the  tissue  on  the  concave  side  of  the 
curve.  The  patient's  legs  should  be  moved 
from  time  to  time  during  this  treatment ;  bu*- 
a  steady  strain  can  be  put  on  the  tissues  of  th<> 
concave  side  of  the  curve  and  allowed  to  re- 
main until  they  relax. 

Pressure  with  the  palm  of  the  hands  over 
the  ribs  and  spine,  while  the  streach  is  on,  will 
aid  materially,  if  intelligently  applied. 


106 


Plate  41— RESISTANCE   TECHN1C   FOR  TREAT- 
ING   A    NECK. 


107 


PLATE  41— RESISTANCE  TECHNIC  FOR 
TREATING  A  NECK. 

When  one  or  more  vertebrae  are  lesioned 
laterally,  they  can  usually  be  replaced  by  this 
resistance  tcehnic.  The  operator  pulls  on  the 
patient's  head.  The  patient  resists  with  al'  her 
might ;  her  muscles,  pulling  on  the  lesioned 
vertebrae,  draw  them  into  normal  position. 

This  method  works  well  for  correcting  the 
second  or  third  cervical  vertebra,  which  often 
is  lesioned  laterally  and  irritates  the  third  cer- 
vical nerve.  This  produces,  in  the  levator 
anguli  scapula  muscle,  the  pain  of  which  the 
patient  complains  in  the  side  of  his  neck.  Ev- 
ery time  he  attempts  to  turn  his  face  to  the 
right  or  left,  the  pain  is  increased. 

In  some  cases,  on  account  of  so  much  hyper- 
sensitiveness  over  the  lesioned  vertebrae,  the 
patient  cannot  permit  pressure  on  the  verte- 
brae to  correct  the  lesion.  For  such  cases,  this 
resistance  technic  is  very  convenient. 


108 


Plate   42— TECHNIC   FOR   TREATING   CHRONIC 
STIFF  NECKS. 


109 


PLATE  42— TECHNIC  FOR  TREATING 
CHRONIC  STIFF  NECKS. 

The  strap  is  put  around  the  patient's  neck. 
The  other  end  of  the  strap  is  fastened  to  the 
handle  at  the  end  of  the  table.  The  patient's 
foot  is  against  one  leg  of  the  table  to  prevent 
the  table  from  moving.  The  head  can  be  given 
any  movement  desired  while  the  strap  is  hold- 
ing the  cervical  vertebrae. 

If  a  stiff  neck  cannot  be  worked  out  by  this 
method,  there  is  not  much  to  be  done  for  it. 

The  treatment  is  not  dangerous,  and  no  harm 
should  come  from  its  use,  if  ordinary  judg- 
ment is  exercised  by  the  operator. 


110 


GENERAL   OSTEOPATHIC   TREATMENT. 


\Yho  needs  a  general  osteophatic  treatment: 
If  one  hundred  osteopaths  answered  this  ques- 
tion, they  would  express  a  great  variety  of 
opinions.  Some  osteopaths  believe  in  specific 
treatments  exclusively.  Others  believe  that  the 
bony  lesion  should  be  corrected  and  the  soft 
tissue,  adjacent  to  and  directly  affected  by  the 
lesion,  should  be  treated. 

Other  osteopaths  believe  in  giving  general 
treatments  because  they  know  that  the  whole 
system  is  affected  by  local  troubles.  They 
know  that  a  chill,  a  fever  and  other  constitu- 
tional symptoms,  arise  from  acute  nephritis ; 
that  chronic  interstitial  nephritis  produces  high 
blood  pressure,  throwing  an  extra  burden  on 
every  organ  of  the  body ;  that,  as  the  kidneys 
are  eliminating  organs,  if  they  fail  to  perform 
their  work,  the  liver  will  be  overworked  in 
its  efforts  tc  eliminate  the  waste  products  of 
the  body ;  that,  if  the  waste  products  are  not 
eliminated  by  the  kidneys  and  the  liver,  the 
sweat  glands  will  be  overworked,  and  will  be- 
come laden  with  waste  products  endeavoring 
to  escape  ;  that,  if  the  waste  products  are  not 
eliminated,  the  blood  becomes  laden  with  them 
and  the  tissues  of  the  body  become  saturated 
with  them  ;  and  that  there  is  no  end  to  this 
chain  of  troubles  until  the  grave  is  reached, 

111 


unless  general  treatments  are  given  to  aid 
in  the  elimination  of  the  waste  products  from 
all  parts  of  the  body  and  to  restore  normal 
organic  functioning. 

Another  osteopath  says  that  general  treat- 
ments are  advisable,  for  even  the  intellect  and 
disposition  of  a  patient  are  governed  largely 
by  the  condition  of  the  body.  He  says  the 
reason  so  many  children  possess  disagreeable 
disposiitons  and  fail  to  make  their  grades  in 
school,  is  defective  nutrition  of  the  brain  sub- 
stance. Howell  says,  "Vasomotor  nerves  to 
regulate  the  blood  supply  to  the  brain  have  not 
been  demonstrated."  Therefore,  general  treat- 
ments with  special  attention  to  the  cervical  and 
upper  dorsal  regions  are  necessary  to  purify 
the  blood  and  supply  the  brain  tissue  with 
good  nutrition.  Children,  so  treated,  grow 
alert,  make  their  grades  at  school,  and  become 
happy  and  agreeable. 

Another  osteopath  believes  that  any  man 
who  works  hard  and  constantly  puts  a  strain 
on  his  nervous  system,  which,  if  continued, 
will  result  in  neurasthenia,  with  its  accom- 
panying symptoms  of  headache,  backache, 
gastro-intestinal,  disturbances  and  a  fatigued 
feeling  on  slight  exertion,  and  that  such  a  con- 
dition, not  marked  by  an  specific  lesion,  must 
be  reached  by  a  general  treatment  to  free  the 

112 


circulation  and  provide  good  nutrition  to  the 
weakened  nerve  cells. 

Another  osteopath  believes  that  if  his  pa- 
tient's heart  musculature  is  weakened,  he  must 
give  not  only  specific  treatment  to  insure  good 
blood  supply  through  the  coronary  arteries, 
and  thus  furnish  the  heart  muscles  with  good 
nutrition  and  plenty  of  it,  but  also  a  general 
treatment  to  the  free  circulation  of  blood 
throughout  the  entire  body,  for,  by  doing  so, 
he  lessens  the  demand  on  the  heart's  strength. 
Thus,  he  would  give  a  general  treatment  in  all 
cases  of  heart  weakness,  even  though  dropsy 
of  the  limbs  or  ascites  has  not  set  in. 

Is  a  general  treatment  detrimental  to  any 
one?  No,  it  can  harm  no  one,  unless  he  is 
very  feeble  or  has  great  soreness  or  extreme 
pain.  As  a  rule,  ninety  per  cent  of  the  office 
patients  can  be  benefitted  materially  by  gen- 
eral treatments. 

There  is  no  tonic  that  can  purify  the  blood 
as  general  treatments  can  do  it.  How  are 
beef,  iron  and  wine  going  to  purify  the  blood? 
I  don't  know.  Who  does?  Chemists  say  that 
all.  the  iron  so  taken,  passes  through  the  body. 
None  of  it  is  assimilated.  Wine  stimulates 
the  heart's  action  if  enough  is  taken.  If  too 
much  is  taken,  it  stimulates  the  tongue.  As 
for  beef,  why  not  buy  it  from  the  butcher, 
rather  than  from  the  druggist? 

113 


On  the  other  hand,  any  one  can  understand 
how  general  treatments  purify  the  blood.  They 
stimulate  the  eliminating  organs  to  such  ac- 
tivity, that,  as  the  blood  is  brought  to  the  kid- 
neys, liver  or  sweat  glands,  the  impurities  are 
taken  out  of  it.  General  treatments  stimulate 
cell  activity,  increase  metabolism  and  throw 
out  waste  products,  like  overhauling  an  old 
house,  tearing  out  the  defective  parts  and  re- 
building with  new  material.  After  completing 
such  a  job,  there  is  a  great  heap  of  trash  to  be 
hauled  away  or  burned.  The  general  treat- 
ment stimulates  the  circulation  of  blood  and 
thus  hauls  the  trash  to  the  eliminating  organs 
to  be  disposed  of.  By  the  general  treatment, 
the  various  glands  of  the  body  are  stimulated 
to  better  work,  accordingly,  the  whole  process 
of  digestion  is  improved,  and  the  waste  prod- 
ucts of  the  alimentary  tract  are  eliminated, 
preventing  absorption  of  their  toxius. 

A  general  treatment  should  prevent  the  ab- 
sorption of  toxic  products.  It  should  increase 
cell  metabolism,  making  every  cell  as  nearly 
perfect  as  possible.  It  should  normalize  all 
glandular  activity  in  the  body,  thus  improving, 
not  only  the  action  of  the  digestive  glands,  but 
the  functioning  of  the  ductless  glands  as  well. 
It  should  free  the  circulation  of  blood,  so  as 
to  lessen  the  work  of  the  heart  and  to  carry 
all  waste  products  to  the  eliminating  organs 

114 


where  they  are  disposed  of.  Thus,  the  blood 
and  all  tissues  of  the  body  become  purified, 
normalized  and  made  healthy. 

If  a  man  is  perfectly  healthy,  a  general 
treatment  would  do  him  no  good ;  but  who 
ever  saw  a  perfectly  healthy  man?  Perfect 
health  is  dependent  on  a  perfect  diet,  perfect 
exercise  of  every  part  of  the  body,  perfect 
ventilation,  regular  rest  and  sleep,  freedom 
from  worry,  fear,  jealousy  or  anxiety,  etc.,  etc. 

There  has  been  so  much  said  in  our  maga- 
zines about  specific  treatments,  I  fear  that 
many  osteopaths  are  failing  to  give  their  pa- 
tients the  benefit  of  general  treatments  as 
they  should.  It  is  all  right  to  conserve  energy 
when  it  can  be  done  without  detriment  or  loss 
to  the  patient ;  otherwise  the  work  should  be 
done. 

For  a  good  general  treatment,  I  would 
recommend  the  manipulations  described  under 
the  following  plates,  to  be  given  in  the  order 
indicated.  Plates  14,  15,  16,  17,  18,  23.  25,  26,  27, 
28,  29,  30,  32  and  33,  and  followed  by  massage 
of  the  abdomen.  This  full  treatment  can  be 
given  in  twenty  minutes.  It  is  well  for  any 
osteopath  who  is  not  familiar  with  strap  tech- 
nic  to  let  someone  give  him  this  general  treat- 
ment before  he  gives  it  to  his  patients.  By 
doing  so,  he  will  know  better  how  to  give  the 
treatment  himself. 

115 


While  giving  a  general  treatment,  add  any 
specific  treatment  that  my  be  indicated,  for 
that,  too,  is  essential.  On  the  other  hand, 
don't  neglect  the  general  treatment,  when  it  is 
indicated,  just  because  some  specific  treat- 
ment has  been  given.  Do  all  for  your  patient 
that  can  be  done.  Then  and  not  until  then  have 
you  done  your  duty  to  your  patient  and  to  the 
profession  you  represent. 


110 


INDEX 


TECHNIC  PERTAINING  TO 

Page 

Abdominal   parites   28 

Acromioclavicular  subluxation  58 

Astride  the  table,  how  to  get  on  37 

Blood,  how  to  purify  it  Ill 

Chest,  expansion  50,  77 

Chest  walls  28,  47 

Costal  region  47 

Curvature,  lateral  spinal  82,  106 

Cerebral  meninges  67 

Cervical  ganglion,  superior  67 

Dorsal  Column,  lower  part  74 

Ear   67 

Equipment   for   strap  technic  5 

Foot   97 

General  treatment  Ill 

Ganglion,    superior    cervical 67 

Headache,   stomach,   vomiting  31 

Hemorrhoids : 22 

Hiccousrh 34 

Hip-joint  99 

117 


Innominate  lesion,  posterior  7 

anterior    7,     9 

"     without    a    strap   10 
"     on  bed  or  sofa....   12 

"     sore   knee   14 

double    14 

Indigestion,  hot  water  treatment  31 

Knee-joint    95 

Kyphosis,  thoracic  28 

Leucorrhea  26 

Ligaments,    sternoclavicular   55 

"  shoulder 47 

acromioclayicular    53 

spinal'  41,  44 

Lordosis    18 

Lumbar  region   74,  99,  102 

Meninges,    cerebral 67 

Muscles,  abdominal  28 

hip    region    , 93 

intercostal    28.   47,  77 

quadratus   lumborum    82.  104 

erector   spinea 18 

quadriceps  extensors  83 

pectoral  22.  47,  77 

"spinal   41,  44,   74,  91 

118 


Neck    67.  71 

"     chronic    stiffened    110 

"     resistance   treatment 108 

Occiput,  posterior  65,  67,  71 

On  the  table,  how  to  get  37 

Otitis  Media  67 

Pelvic    organs    22 

Pectoral  region  47 

Ribs   28,  77.  82 

"     eleventh  and  twelfth  .-..  81 

"     first    52 

Sacrum,  lesioned  14 

Shoulder  47,  80 

straps,  adjustment  46 

Spinal  column 82,  105 

tortion   41 

Half-Nelson    44 

"       curvature,  lateral 106 

Sternoclavicular    articulation    55 

Strap,  how  to  throw  it 39 

Straps  required  for  treating  5 

Superior  cervical   ganglion   67 

Thoracic  kyphosis  28 

region,  lower  part  74 

Throat   67 

119 


Tonsils  67 

Uterus,  displaced  22 

retroflected  22 

Vertebrae,  cervical  62 

upper    dorsal    62 

fifth  lumbar  ....  74 

Vomiting,  preventing   31 

Water,  hot  for  indigestion  31 


120 


r 


Date  Due 


PRINTED   IN    U.S. 


CAT.    NO.    24    161 


WB9UO 
S973  o 

1919 
Swart,  Joseph 

Osteopathic  strap  technic 


S9T3  o 
1919 

Swart,  Joseph 

Osteopathic  strap  t^echnic 


MEDICAL  SCIENCES  LIBRARY 

UNIVERSITY  OF  CALIFORNIA,  IRVINE 
IRVINE,  CALIFORNIA  92664 


A     000417030     4 


Q  Q 

Straps  for  Osteopatbic  Strap  Technic 

You  can  get  a  set  of  webbing  straps  made  at 
a  trunk  factory,  or  I  will  mail  you  a  complete  set, 
for  $4.00. 

A  complete  set,  viz  :— 

3  webbing  straps, each  8  ft.  long,  11/2  m-  wide. 
2  webbing  straps,  each  2 1/2  ft.  long,  li/>  in. 

wide. 

1  webbing  strap  15  feet  long,  1  inch  wide, 
with  two  short  straps  1  inch  wide,  attached  as 
follows,  viz: — 

4  feet  from  the  buckle,  fasten  at  right  an- 
gles, the  end  of  a  webbing  strap  six  inches  long, 
with  a  buckle  on  its  free  end. 

7  feet  from  the  buckle  end  of  this  15-foot 
strap,  fasten,  at  right  angles,  the  end  of  a  web- 
bing strap  40  inches  long,  with  a  metal  tip  on  its 
free  end. 

DR.  JOSEPH  SWART, 
650  Minnesota  Ave., 
Kansas  City,  Kansas. 

Q  O 


